A lot has changed in the five years since I first created Diary of a Disabled Person, so I decided to take a look back at content produced in my first two years of writing and update some of my earliest articles. So, in no particular order, let’s revisit The Many Theories of M.E (originally published 13th May 2018).
It is somewhat depressing that in five years, few developments have been made in our understanding of Myalgic Encephalomyelitis (M.E). We are still unsure as to the causes of the illness, and the physiological mechanisms behind the condition remain unknown to us, let alone any potential treatments or cures. There have, however, been some interesting scientific theories to recently emerge.
The observation that many cases of M.E occur after a severe viral infection has not escaped the notice of scientists, and several medical journals have published articles that propose an auto-immune basis for the disorder triggered by a viral infection. A search for the terms “pathophysiology” and “myalgic encephalomyelitis” in Google Scholar brings up several articles and literature reviews highlighting that increased levels of antibodies specifically targeting human cells are often observed in M.E patients, such as Wirth and Scheibenbogen’s 2020 article “A Unifying Hypothesis of the Pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Recognitions from the finding of autoantibodies against ß2-adrenergic receptors”.
A year later, Wirth and Scheibenbogen also reported that M.E patients can have musculoskeletal disturbances that could give rise to common symptoms such as increased pain and fatigue, quite possibly arising due to the aforementioned auto-immune responses.
Another group of scientists explored the possibility that micro-RNA, a small strand of a molecule similar to DNA that may elicit an immune response, may play a role in the disease and even had the potential to act as a diagnostic measure (Nepotchatykh et al., 2020).
As to which part of the body falls foul of the potential auto-immune response, the general consensus seems to be that the central nervous system bears the brunt of the damage. In particular, a relatively robust review of brain scans of M.E patients points towards issues such as sluggish responses dependent on blood oxygen levels, slow metabolism in the brain, and other such abnormalities (Shan et al., 2020).
This is but a small selection of articles recently published in scientific journals concerning M.E in recent years. While no solid conclusions can be drawn just yet, it is becoming clearer that M.E is not a psychosomatic or even completely imagined illness, but a simple malfunction of physiology just like any other disease.
As callous as it sounds, with the recent influx of people suffering from long-COVID, a condition which bears many similarities to and is quite possibly M.E under a different name, research into this disease may receive better funding and more resource allocations in the coming years. Studies currently ongoing such as DecodeME, investigating the potential for genetic components to the disease, may also uncover interesting findings.
My hope is that, eventually, medicine can no longer brush M.E off by blaming laziness or a need for attention, but I also know that it will take more than scientific evidence to destigmatise the condition. We are a long way off truly understanding this disease and the lack of progress is frustrating, but the science is now very definitely on our side.
Nepotchatykh, E., Elremaly, W., Caraus, I. et al., 2020, Profile of circulating microRNAs in myalgic encephalomyelitis and their relation to symptom severity, and disease pathophysiology. Scientific Reports(10).
Shan Z.Y., Barnden L.R., Kwiatek R.A. et al., 2020, Neuroimaging characteristics of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review, Journal of Translational Medicine(18).
Wirth K., Scheibenbogen C., 2020, A Unifying Hypothesis of the Pathophysiology of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Recognitions from the finding of autoantibodies against ß2-adrenergic receptors, Autoimmunity Reviews(19/6).
Wirth K., Scheibenbogen C., 2021, Pathophysiology of skeletal muscle disturbances in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Journal of Translational Medicine(19).